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Does the Placebo Effect Apply to Exercise?

A couple weeks ago I highlighted a nutrition study that suggested even the body’s hormonal responses (not just self-reported “feelings”) could be impacted by how we perceive a particular food we eat. It’s the kind of thing that I feel like opens up life and health in an amazing way. Let me be clear that I’m not claiming people can abuse their bodies and then erase it all with the magic of positive thinking. I think most people understand it’s positive thought in tandem with positive action that makes for significant, long term benefit. To a point, I’ve always felt there was something to the psychological overlay in health. We’ve all seen it. People give up on their lives after losing a spouse. They approach their lifestyle changes with resentment and cynicism. On the other hand, some people’s health or weight loss takes off once they address underlying emotional issues even though their routine is generally the same. As an elite level athlete, I knew glaringly well how much my mental attitude influenced my performance. As a trainer, I saw every day how much my clients’ expectations helped or hampered their progress. I’ve been curious lately about the measurable impact behind these general observations. Can we, say, examine fitness and the placebo effect beyond intuition and find actual evidence? What does research say, if anything, about the placebo influence on our body’s exercise benefit – and what should that mean for us?
I mentioned previously, of course, the much cited housekeeper study*that measured otherwise unexplained gains in the research sample of hotel housekeepers who were told their daily work met the federal standard for daily exercise. It’s a good place to start because I think too often we apply the concept of positive thinking solely to performance level activity (e.g. marathon winners, Olympic swimmers, etc.).
Yet, the truth is much of the research revolves around performance – and in many studies performance with placebo supplements. Sometimes the placebo effect is studied in a session after a real supplement has been administered in the previous session. The subject then “remembers” and imposes the same benefit (verbally cued by researchers in the second session) onto the “clean” session. It calls into question what exactly constitutes preconditioning in the holistic sense. In one study, for example, lifters improved their output by 3.5-5.2% when they (erroneously) believed they had been given a steroid as they’d experienced in a previous session. Another study found participants doing quadricep work with the suggestion that they’d received a caffeine supplement showed 11% enhancement to their work compared to their previous session. Cyclists produced more power (up to 3.1% over baseline) when they believed they’d ingested a high dose of caffeine. Finally, runners who believed they were being offered “super-oxygenated water” (and watched a video about its purported, but debunked, benefits) ran a 5K session an average of 83 seconds faster (PDF).
This brings me back to everyday fitness endeavors….
The studies out there are few and far between when it comes to general fitness as opposed to performance sessions, truth be told, and they aren’t always consistent. One study sought to replicate the same set-up as the housekeeper research with university custodians. At the end of the study period, however, the two groups showed no significant difference in health measures.
Yet, research is generally consistent in demonstrating psychological effects of exercise even when it’s a matter of perceived versus actual exertion. One study sought to measure the difference in mental well-being in two groups that participated in the same training program. One half was told their program was specifically designed to enhance their psychological well-being, while the other received no message. Although the two groups showed the same VO2 max improvement at the end of the study, the primed group showed a significant advantage in self-esteem assessment.
In a letter to the editor regarding the self-esteem exercise study, one psychologist suggested that the way we think of medical placebo doesn’t entirely match up with psychologically enmeshed situations and that psychological healing and enhancement can come when we are willing to emotionally accept them – the benefit of “effects based on expectations.” One researcher in the area of fitness and placebo even offers that some of the benefits we attribute to better physical functioning are actually the results of psychological effect that comes with exercise.*Of particular note, subjects who perceived themselves as more physically fit were better able to cope with stress regardless of actual activity levels (measured by a device during the study period). The mind-matter question is perhaps more nuanced than we tend to give it credit for.
So, if we can measure the placebo effect as we observe it with food, exercise (and even sleep), is there anything the power of the mind doesn’t influence in terms of functioning on some level? I’m interested to read a new book out just this week by behavior change writer, Dr. Joe Dispenza called You Are the Placebo, in which he not only accounts his own healing from a major accident from which he was never to fully recovery but outlines the research (and a protocol) around placebo and health.
Finally, on a non-exercise but (I think) relevant note, the results of a larger, more general study, showed subjects’ perceived assessment of overall health appears to have an impact on our mortality – a more influential factor than actual health itself. Participants who rated their health as poor were six times more likely to die in the nine-year study period than those who described their health as excellent even when perception didn’t match measured medical reality. If our thinking or the psychological suggestions we accept can apparently impact our mortality risk itself, their potential for influencing our quality of life might be one of the best practices we can cultivate for ourselves.Thanks for reading, everyone. What say you? How has attitude or suggestion influenced your fitness or performance?Join Mark Sisson and Friends at the Mohonk Mountain House this June 5-8! Get Your Tickets for PrimalCon New York Today and Finally Meet Your Tribe!